What function do masks provide generally, whether they’re medical-grade or cloth and paper masks?

Dr. Darien Sutton-Ramsey: There are two main types of masks that people know about. The surgical-style mask — the one you drape over your ears — doesn’t really connect closely to your face, but it covers your mouth and your nose. It would stop your respiratory particles or droplets from going outside. That’s why we stay 6 feet away from each other. We would still suggest practicing social distancing with 6 feet, but wearing a mask adds that extra layer of protection that prevents the respiratory droplets contaminating other people and surfaces.

You usually have to get fit-tested for the N95 mask. You can’t have a beard, you can’t have facial hair, and it needs to sit closely to your face to protect you from respiratory droplets. It’s called an N95 mask because anything larger than 95 microns will not get through this filter.

The CDC really elaborates on the type of mask that you should wear, specifically ones made from cotton, because the idea is that those masks can prevent you from infecting others. With the N95 masks, the goal is to protect others from infecting you.

How do the surgical or other cloth masks keep you from infecting others, if you are a vector for the virus?

Sutton-Ramsey: We have to go back and look at what are the chances of you having an infection without symptoms. There really haven’t been great studies to elaborate on this, because we can’t test everyone who we think might have it. We’re really only testing people who we basically know have it. But we also know this coronavirus is moving around the community in asymptomatic carriers who are transmitting it to those who are vulnerable, who are then getting sick and then placing stress on the healthcare system. So the goal of wearing the mask is to prevent the transmission of those asymptomatic infections.

There’s been a recent study — full disclosure, my twin brother Desmond published the study — where he tested every patient whose babies he delivered at Columbia University for two weeks. It totaled over 200 people. And out of the 200 people he found that 33 of them had COVID-19 and of the 33 who had it, 29 were asymptomatic. That’s almost 90 percent. That just helps people understand that many people are walking around with this virus and just simply don’t know.

CDC is really advocating for cotton, as opposed to other fabrics. Is there a reason why cotton is better, or can other fabrics be used if people don’t have access to it?

Sutton-Ramsey: Certainly, other fabrics can be used. The reason why we talk about cotton so much is because it’s the most easily available. We don’t want to be prohibitive, or make people feel as though they need to buy new materials. The idea is this is something that you can find in your house.

There’s definitely other types of materials that can help; you just have to be aware of what type of material you’re using. A breathable material probably won’t be as effective as cotton because it theoretically would have more tiny holes in it that would allow you to release respiratory droplets that can endanger other people. The main goal is that number one, you want to secure it around your face, and number two, you want to make sure you can still breathe, obviously, while you’re wearing it.

Whenever we go outside, we often see people wearing their masks on their chin. What can people be doing better about mask hygiene?

Dr. Sutton-Ramsey: I spend so much time in the hospital where I’m operating around people who understand how to wear a mask. Sometimes I walk outside and I’m like, what is going on?!

Number one, before you put the mask on, you should always wash your hands. You’re going to bring your hands close to your face, so you want to make sure that you have clean hands.

Number two, when you’re putting the mask on, you can adjust it if your hands are clean, but try your best to avoid being around your mouth. That’s the whole goal.

Number three, when you’re wearing the mask, it should cover both of the holes in the front of your face, which include your nose and your mouth. If you’re wearing the mask just over your mouth, you still can transmit respiratory droplets out of your nose and vice versa.

If you’re going to walk around and not wear the mask, putting it on your chin exposes the inside of the mask to any kind of contamination that may have been on your face and therefore increases your risk of exposing yourself to the coronavirus. So if you’re going to take it off, make sure that you take it off carefully: Wash your hands first, remove it from your ears, and then place it in a secure place where it cannot be contaminated. Don’t wear it on your face or other parts of your body.

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